Purpose. The recommendations justify infection control measures to minimize SARS-CoV-2 transmission in optometry practices. Material and Methods. During January 2020 to September 2022, a literature search on infection control of COVID-19 was conducted in NCBI PubMed, Web of Science, Cochrane COVID-19 study register, WHO COVID-19 Global Literature on Coronavirus linked to the keywords SARS-CoV-2 and COVID-19 with the following links: Transmission, tenacity, risk assessment, screening, protective measures, vaccination, virucidal disinfection, virucidal antisepsis and post-exposure prophylaxis. Results. While the primary vector of transmission of SARS- CoV-2 is the inhalation of virus particles via the oro-naso- pharyngeal path, ocular means of transmission also have to be considered. Especially hand to eye contacts present a danger. Vaccination proves to be effective for decreasing difficult disease progressions and transmission. Surgical masks are effective tools for slowing the spread of SARS-CoV-2, especially when considered as “source-control” when worn by potentially infectious persons. Hand antiseptics, mucous membrane antiseptics and surface disinfectants declared as “limited virucidal” are effective against SARS-CoV-2. Since viral particles remain potentially infectious for up to several days, proper surface disinfection is crucial. Conclusion. Infection control concepts in optometry practic- es have to incorporate interruption of all transmission path- ways of SARS-CoV-2 in this professional field. Professionals and patients should wear surgical masks. Staff should wear masks with a higher protective standard (for example CN95/ FFP2) when treating patients with symptoms of respiratory infections. Personnel should be vaccinated and trained in hand antisepsis. The indications for surface disinfection of critical surfaces and equipment must be maintained. Any staff showing signs of respiratory infections is to be tested immediately; contacts to COVID-19 positive persons have to be tested for 5 d daily. After contact with possibly or definitely infectious person virucidal gargling and virucidal nose spray may prove beneficial. Keywords SARS-CoV-2, tenacity, anamnestic risk assessment, infection control, personal protective equipment, disinfection, antisepsis, screening, post-exposure prophylaxis

Corrected by: Perioperative Antibiotikaprophylaxe: ein UpdateKrankenhaushygiene up2date 2015; 10(02): e1-e1DOI: 10.1055/s-0034-1392967

Das diabetische Fußsyndrom (DFS) ist ein Krankheitsbild mit wachsender Bedeutung wegen der erheblichen Beeinträchtigung der Betroffenen, der zunehmenden Häufigkeit und des immensen Ressourcenverbrauchs. Wesentliche Aspekte der Diagnostik und der Therapie werden durch tradierte Vorstellungen geprägt und sind nicht geklärt.

The problem of wound infection presents a special challenge in the treatment of acute as well as chronic wounds. Typical complications not only jeopardise the successful outcome of treatment modalities as a whole; they may result in amputation or even become life-threatening.Polihexanide is an antimicrobial substance which is highly appropriate for use in critically colonised or infected acute and chronic wounds. This finding is based primarily on the broad antimicrobial spectrum and good cell and tissue compatibility of polihexanide, its capability of binding to organic matrix, the low risk of contact sensitisation, and the fact that it promotes wound healing. Furthermore, there has been no conclusive evidence to date of any pathogens developing resistances under the use of polihexanide.Summary: Wound infections are special and challenging situations in therapy of acute and chronic wounds. Typical complications are riskful not only for therapeutic process but also for amputation and viability of patients.Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and tissue tolerability, the binding capacity to organic matrix, low risk of contact sensitisation and adjuvant effects to wound healing. Up to now there are no microbial resistances observed. (C) 2010 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Methicillin resistance of Staphylococcus aureus strains (MRSA) has become a steadily growing cost factor for the German and international health system. Besides direct costs for diagnostics and therapy, indirect and intangible costs are a considerable part in the total expenses. Because of the massive increase of MRSA in medical centres as well as in the population and further worsening of forced rationalizing in the health care systems, the interest in the economic effects of this phenomenon has increased greatly during the last years. For managing MRSA and for effective cost containment, especially in hospitals, infection control measures have not only to prevent the further spread of MRSA but actively reduce the number of colonised patients. In the last years the efficiency of several infection control measures and their combination to prevent the spread of MRSA has been shown. However, these measures are linked to considerable direct costs in the first place. Nevertheless, an overall economic assessment of hygiene measures is only possible after a complete cost-benefit analysis, where costs are compared to effects achieved. Moreover, analyses that focus on effects for single institutions only are as inappropriate as purely monetary analyses or analyses that include the direct additional only. Despite of at first considerable expenditures, not only infection control measures but proactive strategies to reduce the total number of MRSA cases (accordingly of the "Search and Destroy" philosophy) are shown to be cost efficient, even in low prevalence situations, based on examples in literature. Hence, effective programmes to reduce MRSA are not only necessary from a medical and ethical focus but are also cost efficient in medium term for health care providers and the community.

Background: Patients with atopic dermatitis (AD) have an increased tendency to develop bacterial skin infections. Colonization with Staphylococcus aureus is known to be a major trigger and might also play a pathophysiological role. Because of their antiseptic action, silver-coated textiles suppress S. aureus colonization and toxin formation, thus damping the inflammatory reaction.Objectives: To evaluate the clinical effectiveness and safety of a special silver textile in the treatment of patients suffering from acute AD.Methods: In a randomized phase II monocenter parallel-group comparative study 30 patients were recruited (average age 25.5 years, min. 4 years, max. 70 years) who were affected by AD in an acute phase. During the first study phase from Day 1 to Day 14, 10 patients received a silver textile (Group 1), 10 a silver-free textile (Group 2), and 10 prednicarbate ointment (Group 3). In the second phase from Day 15 to Day 28 all patients wore the silver textile, and during the follow-up period from Day 28 to Day 56 no textiles were used. Prednicarbate ointment was allowed as emergency medication, but ointment consumption was measured. The overall severity of the disease was evaluated using the SCORAD index as the primary efficacy parameter. Secondary parameters included severity of pruritus and the patients' assessment of their disease control (uncontrolled, limited, good or complete). Safety tests included hematology, blood chemistry, urinalysis for silver, and physical examination for silver deposits in the skin and mucous membranes.Results: The initial SCORAD was 61.6 (IQR 26.6, min. 30.6, max. 99.9). At the end of the Study Phase 1 the SCORAD had improved significantly in the patients of Groups 1 (74.6-29.9, p = 0.005) and 3 (57.8-24.0, p = 0.009). During Study Phase 2 healing of eczema continued in Group 1 (SCORAD 29.9-18.1, p = 0.037), was observed in Group 2 (48.2-24.1, p = 0.015), and remained at an improved level in Group 3 (SCORAD 24-23.5). Consumption of prednicarbate ointment (Phase 1, Phase 2, follow-up period, medians are given): Group 1: 135g, 10g, 45g; Group 2: 13g, 0g, 0g; Group 3: 145 g, 30 g, 90 g. Silver textiles reduced the severity of the pruritus (p = 0.031); silver-free textiles (n.s.) and prednicarbate (n.s.) were less effective. No undesired events were observed.Conclusion: The elastic silver textile worn directly against the skin led to an impressive improvement of AD and a reduction in the use of prednicarbate ointment.

OBJECTIVESFor various clinical applications, polyhexamethylene biguanide hydrochloride (PHMB) has been used for many years as an antiseptic in medicine. Recently, a 0.04% PHMB mouthwash was shown to inhibit plaque regrowth and to reduce oral bacterial counts. In this study, a 0.12% PHMB mouthrinse (A) was compared with a negative control placebo rinse (10% ethanol, flavour) (B), a positive control 0.12% chlorhexidine rinse (C), and a commercially available mouthrinse containing essential oils (Listerine) (D).MATERIALS AND METHODSThe study was a double-blind, randomised 4-replicate 4 x 4 Latin square cross-over design in which plaque regrowth was measured. The in vivo antibacterial effect was assessed by taking bacterial counts from the tooth surface and mucosa 4 h after the first rinse with the preparations on day 1 and prior to the clinical examination on day 5. 16 volunteers participated and, on day 1 of each study period, were rendered plaque-free, ceased toothcleaning, and rinsed 2x daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. Washout periods were 9 days. Data were analysed using ANOVA with Bonferroni HSD adjustment for multiple comparisons (significance level alpha=0.05).RESULTSThe 0.12% PHMB mouthrinse (A) was significantly more effective in inhibiting plaque than the placebo (B) but no significant differences could be observed between A and 0.12% chlorhexidine (C), or between A and Listerine (D). Bacterial count reductions on the tooth surface with PHMB (A) were significantly greater compared to the placebo (B) after 4 h and significantly greater compared to B and D after 5 days. Chlorhexidine (C) was more effective than A after 5 days. On the mucosa, chlorhexidine (C) was significantly more effective in reducing bacterial counts than the other 3 treatments at both time points investigated. PHMB (A) was significantly more effective in reducing bacterial counts than the placebo (B) after 4 h and after 5 days, and than D after 4 h.CONCLUSIONConsistent with a previous study, a PHMB mouthrinse was shown to inhibit plaque recolonisation and to reduce oral bacterial counts, indicating that PHMB may find applications in the prevention of plaque-associated diseases.

OBJECTIVES:A 10-week, double-blind, placebo-controlled clinical study on 140 male subjects was conducted to determine the effect on plaque and gingivitis of 5 dentifrices containing various thiocyanate (SCN-)/hydrogen peroxide (H2O2) combinations.MATERIALS AND METHODS:The dentifrices consisted of a gel base without any detergents or abrasives (placebo, group A) to which SCN- and/or H2O2 were added as follows: 0.1% SCN- (group B), 0.5% SCN- (group C), 0.1% SCN-/0.1% H2O2 (group D), 0.5% SCN-/0.1% H2O2 (group E) and 0.1% H2O2 (group F). A baseline examination was performed in which the Silness and Löe Plaque Index (PI), the Mühlemann and Son Sulcus Bleeding Index (SBI), and the amount of gingival crevicular fluid (GCF) were recorded using the Periotron 6,000 on teeth 16, 12, 24, 36, 32, and 44. The subjects were randomly assigned to either the placebo group (n = 40) or one of the test groups (n = 20) and used their respective dentifrices over a period of 8 weeks. Finally, each group used the placebo for another 2 weeks (wash-out). Re-examinations were performed after 1, 4, and 8 weeks and the 2-week wash-out period employing the clinical parameters used at baseline. Intragroup changes were analyzed with the Wilcoxon signed-ranks test, using the baseline and wash-out points as references. The Mann-Whitney U test was used for comparisons between the treatment groups and the placebo group.RESULTS:At the 8-week examination, the plaque index in group E (p = 0.017) and group F (p = 0.032) was lower than in the placebo group. The Sulcus Bleeding Index in group F after 1 week was increased (p = 0.023) and the SBI in group E after 8 weeks was reduced (p = 0.047) as compared to the placebo group.CONCLUSION:The results demonstrated that a dentifrice containing 0.5% SCN- and 0.1% H2O2 but no detergents or abrasives inhibited plaque and decreased gingivitis.

OBJECTIVES:For various clinical applications, polyhexamethylene biguanide (PHMB) has been used for many years as an antiseptic in medicine. Little is known, however, of its antibacterial activity in the oral cavity and its ability to inhibit plaque formation. In this study, a 0.04% PHMB mouthrinse (A) was compared with a negative control placebo rinse (10% ethanol, flavour) (B) and 2 positive control chlorhexidine rinses, one of which was a 0.12% aqueous solution (C) and the other a commercially available mouthrinse (Skinsept mucosa) diluted to a chlorhexidine concentration of 0.12% (D).MATERIAL AND METHODS:The study was a double-blind, randomised 4-replicate 4 x 4 Latin square cross-over design. Plaque regrowth was assessed with the Turesky et al. modification of the Quigley and Hein plaque index. The in vivo antibacterial effect was assessed by taking bacterial counts from the tooth surface (smears from the lingual surface of 16) and mucosa (smears from the buccal mucosa) 4 h after the 1st rinse with the preparations on day 1 and prior to the clinical examination on day 5. 16 volunteers participated, and on day 1 of each study period were rendered plaque-free, ceased toothcleaning, and rinsed 2x daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. Washout periods were 9 days. Data were analysed using ANOVA with Tukey HSD adjustment for multiple comparisons (significance level alpha=0.05).RESULTS:Mouthrinses A, C, and D were significantly more effective in inhibiting plaque than the placebo (B). Mouthrinse C was significantly better than mouthrinses A and D, while mouthrinses D and A were equally effective in inhibiting plaque. Bacterial count reductions on the tooth surface with mouthrinse C were significantly greater compared to mouthrinse A and the placebo (B). The reduction of bacterial counts on the mucosa with C was significantly greater than with A and B after 4 h and significantly greater than with A, B and D after 5 days. Mouthrinse A reduced bacteria on the mucosa significantly more effectively than the placebo (B) after 4 h and 5 days, while mouthrinse D was more effective than the placebo (B) after 4 h.CONCLUSION:The results indicate that a 0.04% PHMB mouthwash inhibits plaque regrowth and reduces oral bacterial counts, and may be used in preventive applications in the oral cavity.